Basal Cell Carcinoma

The majority of basal cell carcinomas are nodular type. It is composed of waxy partially translucent nodules that form around a central depression. This type often has a shiny or pearly appearance when light hits at a certain angle. Under magnification you can often visualize small vessels traversing across the tumor. Bumping the lesion will often lead to bleeding.

Morpheaform basal cell carcinoma also referred to as cicatricial makes up about 2-6% basal cell carcinoma subtypes. Clinically it appears as a white sclerotic flat lesion that can resemble a scar. It may ulcerate and become crusted. Blood vessels can be seen traversing the lesion but less commonly than in the nodular subtype.

Infiltrative subtype of basal cell carcinoma largely gets its name from how the tumor cells look under the microscope. The cells under high magnification form spiky islands that demonstrate an invasive pattern. It is important to recognize this pattern under the microscope in order to get proper treatment. Clinically these lesions can look like any of the other subtypes of basal cell carcinoma.

As the name suggests, superficial basal cell carcinomas are superficial in the skin and not running deep. They are only in the top layers of the skin and are unlikely to be invasive. Clinically it will present as a slightly elevated dry crusted skin lesion. These are more common than morpheaform and infiltrative subtypes but less common than nodular basal cell carcinomas. Given the superficial nature of the tumor it will tend to follow a more indolent course.